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Understanding Concussions and How Chiropractors Can Help

In light of recent news from the Pittsburgh Penguins regarding Sidney Crosby sustaining another concussion during practice last Friday, the hockey community is a buzz. Crosby’s concussion history is well documented of recent, having sustained three in less than six years. Discussions and speculations of what this means for Crosby's season, and even career, are populating the Internet and sports talk shows.

Despite the advances in sports medicine as it relates to concussion diagnosis, management, and return to play guidelines, concussions remain a challenging condition for all involved.

The reality is concussions are truly challenging. Despite measures to "prevent concussions", concussions are not preventable. There is no such thing as concussion prevention. There is no single piece of equipment, be it a helmet or mouth guard, that is capable of preventing a concussion. Rather than prevention, the focus is on minimizing concussion rates through proper identification, management, and education.

Consider that within the United States, there are over 300,000 sport-related concussions per year and research suggests concussion rates are on the rise. If your child is in contact sports, there’s a risk of concussion. Thus making this is an extremely relevant conversation and one that shouldn't be taken lightly. That said, the goal of this article is to offer insights into what a concussion is, how they should be managed, and the chiropractors potential role in the process.

What is a concussion?
A concussion is a traumatic brain injury defined as a short-lived loss of brain function due to trauma that resolves spontaneously. With a concussion, there is no structural damage to the brain. Simply put, only brain function is altered.

Encased within the the skull, the brain floats in a pool of fluid, known as cerebrospinal fluid.  These protections allow the brain to withstand many of the minor injuries that occur in day-to-day life. However, if there is sufficient force to cause the brain to bounce against the bones of the skull, then there is potential for injury. It is the impact of the brain against the inside of the skull that cause the brain to be injured and interrupt its function. This impact is often due to rapid acceleration and deceleration movements of the head and neck. Rapid acceleration and deceleration of the head and neck can be created from a direct blow to the head or from impact that results in whiplash injury common in motor vehicle accidents and falls.

How are concussions diagnosed and treated?
First and foremost, anyone suspected of having a brain injury should seek evaluation by a neurologist trained in concussion evaluation.

The signs and symptoms of concussion may be obvious or very subtle. Most concussions are sustained without the individual losing consciousness or "blacking out". In several cases, the individual may not be aware they have sustained a concussion or may not connect their symptoms with a head injury. Complicating the picture is the fact that some individuals may have delayed onset of their symptoms, not presenting with concussion symptoms for several hours or days after the initial injury.

Typical symptoms of concussion include:

  • Headache
  • Difficulty concentrating or feeling “foggy”
  • Poor recall or memory of recent events
  • Changes in mood or personality
  • Slower reaction times
  • Dizziness, lightheadedness
  • Nausea or vomiting
  • Low tolerance of bright lights or loud sounds
  • Irritability
  • Changes in sleep patterns, such as being unable to sleep or sleeping more
 
In some cases, chiropractors can be the first point of access for individuals who recently sustained a head or neck injury, such as those occurring in sports, car accident or fall. Chiropractors, especially ones who are certified by the American Chiropractic Rehabilitation Board, regularly manage athletes who suffer sports injuries, such as concussions, and are trained in proper diagnosis and understand the importance of referral for additional medical evaluation. Gallagher Performance offers such quality in their chiropractic services and has been part of the co-managment team in a number of concussion cases.

An effective tool chiropractors may use to assess the severity of a concussion is called the Sport Concussion Assessment Tool 2 (SCAT2). The SCAT2 is used to evaluate, assess, and manage concussions in athletes 10 years and older with the end goal of safely returning the athlete back to the sport.

How are concussions treated and what is the Chiropractors role?
After evaluation, rest is the best treatment. Depending on severity, most symptoms resolve relatively quickly while treatment is directed at symptom control for headaches, nausea, dizziness, and sleep problems. Rest does not simply mean physical rest. Brain rest is equally important as physical rest. Exposure to television, computers, and smartphones and other devices can stimulate the brain and aggravate symptoms. Limiting use of those devices may be helpful in allowing the brain to recover more quickly. Brain rest may also involve student-athletes being held out of the classroom and encouraged not to read, study, or taking exams as this mental effort can aggravate symptoms and possibly delay healing.

When it comes to management and, for athletes, return to play guidelines, often a team of medical professionals are involved. Chiropractors may find themselves as part of this co-management team.

Chiropractors may not be the first medical professional you imagine when it comes to concussion management and treatment, but sport and rehabilitation chiropractors are trained to support the patient during the recovery process. Largely this is due to their focus on treating spinal joint dysfunction present in the head or neck, myofascial techniques to restore muscular and connective tissue function, and sensory-motor based exercise protocols to restore ideal neuromuscular function. For further consideration, two recent literature reviews outlined how chiropractors can effectively manage athletes with concussions (1,2).

Ultimately, the brain will recover at it’s own pace. For athletes, return to play guidelines are established to ensure they are safe to return to sport competition. This involves the close observation of the athlete to ensure no symptoms are present during gradual exposure to increased cardiovascular demands all the way to more intensive and sport-specific measures.

Dear Patient, Be Patient
While 80 - 90% of individuals who suffer a concussion will recover within 7 - 10 days, some will experience symptoms for weeks or months. The length of recovery is not necessarily related to the extent of the initial injury.

Employers or school officials should be informed of the concussion diagnosis and aware of potential issues of poor performance due to difficulty with concentration and comprehension. Return to sport is fully dependent upon complete resolution of concussion symptoms and this decision should come from the neurologist overseeing care. Remember to be patient. The brain is a delicate structure and will heal with time. Don’t rush your recovery process. Returning too quickly can put you at increased risk for worsening your previous condition. Let the brain recover and reboot.

Gallagher Performance has extensive training and experience in evaluation and co-management of patients and athletes who have sustained a concussion. Our experience allows us to assist in providing gold standard care when it comes to concussions.

This blog post was written by Sean Gallagher, DC, DACRB, PES
To schedule your appointment, call (724) 875-2657.

References
Johnson, C.D., et al. Chiropractic and concussion in sport: a narrative review of the literature. Journal of Chiropractic Medicine 2013 (12):216-229.
Shane, E.R., et al. Sports Chiropractic management of concussions using the Sports Concussion Assessment Tool 2 symptom scoring, serial examinations, and graded return to play protocol: a retrospective case series. Journal of  Chiropractic Medicine 2013 (12): 252-9.
 
 

Understanding Methods and Application in Training and Rehab

It seems, inevitably, we get weekly questions wanting our insights or thoughts on some training or rehabilitation method.

Regardless of the whether its the fitness industry or physical medicine profession, methods come and go all the time. Some interventions have staying power as they provide lasting results. Some trends are just a flash in the pan. The more recent or more intriguing the trend, the more it seems to generate questions.

When it comes to rehabilitation, this can be seen in a wide range of modalities and procedures from electromuscular stimulation (EMS) to low level laser therapy, machine-based exercises to the functional approach, stretching to myofascial release techniques, and kinesiotaping to cupping.

In the fitness and training industry, there is an equal (likely greater) amount of options and trends to get hung up on. From kettlebells to TRX, Curves to Crossfit, bodybuilding methods to Olympic weightlifting, and unstable surface training to over-speed training just to name a few.

While the question, "What do you think of....," may be seem to be a simple question in nature, it's a difficult question to answer without understanding the context of it's application.

Unless the application is understood, the results one gets from a specific method is left in question.

If you severely sprain an ankle during a basketball game, sure taping and bracing will help in the early stages of healing. As healing and rehabilitation progress, manual therapy and exercise begin to take more focus. Single-leg balance and sensory-motor stimulation have demonstrated successful application in the rehabilitation of certain injuries, such as ankle sprains. But if you get on a BOSU ball or unstable surface too soon - and you re-injure your ankle - is the problem the unstable surface or just poor application?

Similarly, there are many people who take on a fitness or sports training program but end up worn down and banged up because their application of certain principles is just wrong. This may be due to joining a group exercise class or working with a trainer that provides poor advice and application of training principles. Or it could be due to an individual attempting to structure their own exercise program without proper knowledge of training method applications.

We all could benefit from someone who we can trust for sound advice who it comes to applying the principles of rehabilitation or exercise. They will be able to inform you on what methods may be best for your specific goals and your unique individual considerations. You need someone who can help guide and educate you, who is able to critically think and problem solve. This is what the best trainers, coaches, and therapists are able to do for their clients and athletes.

What we do at Gallagher Performance is exactly that. We critically think and problem solve for our clients and patients. We aim to educate them and implement the most appropriate applications for their desired goals and outcomes.

Despite this, the reality is our philosophy, our approach, or our applications may not be for everyone. We won't sacrifice long-term sustainability for temporary results. We take pride in quality over quantity. We won't focus on the latest trends or what other people are doing. We aren’t concerned with this.

Our primary concern is offering the best training and therapy to the people we work with while educating them on understanding sound application so they are able to make informed decisions. And we will always educate, even if that means people have to hear the hard truth. But hopefully in hearing the hard truth, they learn lessons that provide better guidance in the pursuit of their goals.

More related reading:

https://gallagherperformance.com/prevent-re-injury-integrated-training-rehabilitation/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/the-benefits-of-performance-therapy/

A Solution to Headaches

Headaches are among the most frustrating and debilitating conditions seen by healthcare practitioners, from primary care physicians to chiropractors. When severe enough, headaches may interfere or prevent even the most basic daily activities that we take for granted, such as thinking, talking, and reading.

While a logical assumption would be that the origin of headaches is in the head itself, science suggests many of the most common headaches are generated from the joints, muscles, and nerves of the neck.

The head and neck is an inherently unstable system that requires a complex neuromuscular system to surround the spinal column for control of movement and protection from injury. 

Many daily activities, such as prolonged sitting and poor posture, can affect the function and health of the joints, muscles, and nerves of the neck. Poor posture or prolonged postures common to students and the majority of the working class can lead to muscular imbalances, restricted joint motion, and unnecessary strain on the neck and upper back often responsible for headaches.

Referred pain and micro-trauma explain how this strain often results in headaches. Referred pain is a neurological phenomenon which is responsible for the perception of pain at a location other than where the problem exists. Using the headache as our example, the problem exists in your neck or upper back, yet your symptoms and perception of pain exists in your head. Micro-trauma is cumulative, small scale damage that occurs in and between soft tissues (muscles, tendons, joint capsules, ligaments and nerves) in response to strain. The bodies response to this strain is to lay down small amounts of repair tissue. Over time, a build up of repair tissue can form adhesions or scar within the soft tissue altering function. Left untreated, these adhesions often lead to pain, tightness, stiffness, restricted motion, and diminished blood flow. The result is a negative feedback cycle, the cumulative injury cycle.



So how do we stop the cycle?

Massage therapy, myofascial release, and IASTM (instrument assisted soft tissue mobilization) techniques are just some of the tools utilized at Gallagher Performance to address scar tissue adhesions and neurological dysfunction in soft tissue. Along with these tools, we often utilize chiropractic manipulative therapy (adjustments), sensory motor stimulation, and Dynamic Neuromuscular Stabilization (DNS) to improve posture, positional awareness, and help restore muscular balance. The combination of these therapies have helped numerous patients find a solution to chronic headaches or migraines.

The next time your dealing with a headache, consider Gallagher Performance. There is a solution to headaches that doesn't involve taking medication. Call our office at (724) 519-2833 to schedule your appointment.

More related reading:

https://gallagherperformance.com/fascia_muscular-adhesions_how_they_relate-_to_pain_and_overuse_injuries/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/why-stretching-wont-solve-your-tight-muscles/

Summer Grind, Summer Blast

Lately it’s hard to find time to keep up with our blog. Life and business have a way of keeping you busy. Ignoring our social platforms may happen for a period of time, but we always revisit them. If there is one thing I’ve always hoped is that our blog would be informative, educational, and entertaining (at times).

The summer months bring on increased work load. Once May rolls around, we take it up a notch or two at Gallagher Performance. Summer is a grind, but it’s also a blast. We love the grind, love the process. With the volume of high school and collegiate athletes training for strength and performance, along with the patients we see ranging from acute care to rehabilitation to return to play, summer provides tremendous learning opportunities.

Reflecting back on the past several weeks, there are some friendly reminders and lessons learned or re-learn that I wanted to share:

  • Power-speed athletes thrive on power-speed drills and exercises. Just because one can squat or deadlift 500+ doesn’t mean they are explosive and fast. Yes athletes need strength and for many they will need a primary focus on strength training. However, those newly acquired strength levels must also be displayed in more power-speed dominant means such as sprints, jumps, throws as they have greater specificity to athletics than anything barbell related.
  • Athletes need to rapidly absorb force and rapidly generate force and do it on a level of unconscious activation. That brings me to another point of muscle activation. Muscle activation is a craze nowadays and rightly so. The overwhelming majority of the population will benefit tremendously from learning how to activate and integrate muscles such as their tibialis anterior, glutes, and scapular stabilizers to name a few. A lost art in muscle activation seems to be the use of isometrics. There is always an isometric contraction during the amortization phase of movement. Even during the most explosive movements, there is an isometric contraction. Isometrics are also awesome for reprogramming and generating a powerful mind-muscle connection, making isometrics a great tool for performance as well as rehabilitation. We have been utilizing a select few isometric drills for uprighting, motor control, and priming for improved  force/strength generation. In a relatively short period of time, they have more than demonstrated significant value.
  • There is a right way to go about training and a wrong way. The right way will always be dependent on the needs of individual and their specific goals. Don't get caught up in hype, trends, and empty promises. Trust the tradition. There is magic in the basics of the barbell, free weights, sprints, jumps, and bodyweight drills. They have stood the test of time. Fads and trends come and go, the basics remain. Using these exercises is one thing, understanding how to structure them in a training plan is another animal in itself. Find a trainer/coach that understands training specificity or else you are simply wasting your time and money.
  • We are problem solvers. Either as a clinician or trainer/coach, the heart of what we do is problem solving. Maybe it’s a matter of ability or effort, but clinicians or trainers either have the ability or they don’t. The ability to problem solve comes from knowledge and experience and even instinct. When it comes to effort, frankly some are just lazy and don’t care to think hard as it complicates their job. Whether it is listening to what a patient/athlete is telling you or just simply watching, you’ve got to process the source of the problem and how you’re going to solve it. When it comes to performance or rehabilitation, everything makes sense. If it is happening there is good reason for it. If we don’t understand it, it doesn’t make sense to us, but it always makes sense. Never dismiss a client or patient as not making sense. Make the effort to make a change. Change your perspective. Learn more.
  • We all need a coach. No one gets through life all on their own. We all have needed mentors and coaches at some point in our life. These may have been parents, family members, close friends, teacher, professors, bosses, etc. If we pursue something of significance, chances are someone helped us along the way. We need the help of others than have more knowledge, more experience, more accomplishments. I have had a number of mentors and coaches. For everything they did for me, I hope I can pass that on to those that I work with in the role as a coach.
  • Take time to get to know your clients and athletes. Show you care about them. We do more than just simply get kids bigger, stronger, or faster. We have an opportunity everyday to connect with our clients and athletes and hopefully make a positive impact. The reward goes far beyond cash flow. It’s about making a difference for the better.
That’s all for now. Thanks for reading and enjoy the grind!

More related reading:

https://gallagherperformance.com/do-you-really-need-more-mobility/

https://gallagherperformance.com/faqs-frequency-avoided-questions-of-strength-conditioning/

A POWERFUL, INNOVATIVE APPROACH TO IMPROVING HOW THE BODY FUNCTIONS

The Gallagher Performance approach will improve the way your body moves and functions. 
Simple yet effective changes to improperly functioning muscles and joints will allow the body to make immediate shifts toward working as a functional unit. Thus reducing pain and enabling higher levels of strength, speed, and power with greater resilience.

The results are incredible. Time and time again, our patients and athletes quickly change from a state of pain and tension, to a state of relaxation primed for performance. This all comes back to assessment and knowledge. When we do the right thing, the body responds immediately.

The methods used at Gallagher Performance are utilized internationally by elite athletes, sports teams, and health practitioners. Not only are we able to efficiently and effectively treat injuries and enhance sports performance, our methods are also powerful tools for stress management, quickly breaking common patterns of movement dysfunction related to chronic pain. The methods have international recognition and no provider, therapist, or trainer in the Pittsburgh area has  the training and background in these methods that Gallagher Performance offers, making us truly unique. 
HOW DOES THE GP SYSTEM WORK?
Our body is designed to breathe and move. In order to breathe and move, our body finds ways to accomplish these tasks, and it’s willing to do so in efficient or inefficient ways. Our breathing and movement can develop compensation patterns or “key dysfunctions” that become the target of successful musculoskeletal treatment.

These compensation patterns cannot be ignored, as they put us at risk of poor sport performance, tension, or pain.  Our body’s ability to overcome the stress of life can result in reduced movement quality and energy levels. Measurable reductions in stability, strength, power, mobility, and stamina are often the result. Our body becomes less resilient, increasing the chance for fatigue and breakdown.

If you experience a traumatic event or injury, you know exactly what I’m talking about. Post injury, you’ll notice the slow and gradual decline in energy, function, and performance. Compensations begin to manifest in order for us to avoid pain and accomplish daily tasks. The result may range from noticeable decline in energy, to impaired function of muscles and joints, to chronic pain which long outlasts the initial injury.
It is almost inevitable nowadays for the majority of us to experience the effects that stress, injury, and/or compensation has on the human body.  And it can be simple to reverse those effects when you focus on what your body needs to regain ideal function.
The system at Gallagher Performance starts by testing how your body is currently functioning, so that changes can be clearly measured. This is accomplished through evaluating joint restriction, muscle activation and strength, and functional patterns of movement.

Once compensations are identified, we target “zones” to help activate the body to perform better. These “zones” can be a specific muscle, group of muscles, joints, or a combination.

Once we activate, we have to integrate. In order to do this, we run through the body’s movement patterns, testing and activating along the way to enable muscles and joints to regain their ideal function. Then through cueing and exercise, the brain can integrate improved patterns of movement, allowing you to move effectively and efficiently.

A body that moves better has less stress and less pain, allowing you to work at greater capacity and with greater energy.
That doesn’t mean you’ll suddenly be indestructible for the rest of your days. That would be too good to be true. After all, it you enjoy being active and testing your body’s limits, you are going to feel it. Our movement patterns need reminding and that’s why we use targeted home exercises to help the body reinforce ideal function and keep compensations from returning.

The methods and techniques used at Gallagher Performance are proven to be effective in getting people out of pain and elevating performance. We truly offer unique, powerful tools for control over your own health and performance.
More related reading:

https://gallagherperformance.com/chiropractic-rehab-dns-treatment/

https://gallagherperformance.com/tendinitis-changing-treatment-and-improving-recovery/

https://gallagherperformance.com/improved-approach-chronic-pain-management/

Prevent Re-Injury with Integrated Training and Rehabilitation

The majority of us will not get through life without sustaining some degree of injury. The joints of the back, shoulder, hips, knees and ankles are all very common injury sites for not just athletes, but the general fitness population as well.

Most injuries that develop over time tend to have one thing in common, a breakdown in the human movement system. Meaning it could be that you are performing specific movements with sub-optimal technique or perhaps muscle imbalances are responsible for your symptom presentation. Regardless of the reason for injury, the goal is the same; to make movement more efficient to ensure that once training or competition resumes, the chance of re-injury is minimal.

Efficiency of movement is rarely a goal achieved in therapy. Incomplete rehabilitation in athletes and the general fitness population has lead to a re-injury epidemic. The problem is rooted in either the push to return athletes to the field as quickly as possible or rushing patients through the rehabilitative process.

With the ever changing landscaped of health insurance, the overwhelming majority of athletes and patients deal with increasing out-of-pocket expenses and limited number of therapy visits. Ultimately, many patients never complete their rehabilitation process.

This may be for a number of reasons, but in most cases athletes or patients are discharged once specific objective and ADL (activities of daily living) measures are satisfied. Sure you may have minimal to no pain, full range of motion and seemingly adequate strength resorted, and basic activities are easy to perform, but this does not ensure you are ready to resume training and competition.

And this is exactly where most get stuck.

They are lead to believe they are ready to resume sport training or their exercise program, but soon after resuming they realize they aren't as ready as they thought they were.

The transitional period between rehabilitation and performance-based training is the most critical period to ensure complete rehabilitation and that the transition back into training and competition carries minimal risk of re-injury.
Sadly, due to points made previously about the state of healthcare, many personal trainers and strength coaches are finishing off the rehab process.

Why do I say sadly?

Frankly, the majority of personal trainers aren’t educated enough to be overseeing such a delicate process, yet many position themselves as psedo-therapists. I’ve lost count of how many personal trainers I’ve seen giving “massage” or performing “joint mobilization” during their training sessions. They have no training or qualifications to perform such work and ultimately the person at most risk is the individual they are working on. Word to the wise: if your personal trainer is performing such work on you and has no license to perform such work, run the other way and seek out a qualified professional.
Within the fitness industry, there has been a large growth in facilities that blend rehabilitation with prevention strategies within strength and performance based training programs. Done well and overseen by qualified professionals, this is a great way to manage what is seen both in a rehab and training setting. This process should not be handled improperly. Implementing “corrective” or therapeutic exercises strategies into a performance-based training program should be lead by qualified professional(s). There used to be a gap between the professionals in the therapy and strength & performance world. Progressively though, that gap is slowly closing as more therapists crossover into the world of strength & conditioning.

Returning from injury isn’t and shouldn’t be a quick process. It’s far better to train smarter through the process. Improving on the function of the body while adding qualities such as endurance, strength, reactivity, power, etc. will help ensure successful outcomes. It’s less about isolation and more about training systematically to re-groove movement patterns. For anyone who has suffered an injury, they all want to get back to their previous level of function while also building the confidence they will not re-injure themselves. It can and will be a detailed process that involves rest, manual therapy directed at specific joints and soft tissues, as well proper exercise progressions. And yes, this means regressing, substituting, and even just slowing down exercises until they are owned.

Once movement and exercises are owned, it opens the door to further progressions in a performance-based setting to help ensure a more complete rehabilitation resulting in reduced risk of re-injury. This has become a huge part of what we do at Gallagher Performance as we successfully help our athletes and patients resume an active, pain-free lifestyle.

More related reading:

https://gallagherperformance.com/technique_and_performance/

Low Back Pain Treatments That Just Won't Help

Back pain was believed to be a self limiting condition for the majority of individuals, meaning that the nature of back pain is that it would "run its course" and eventually pain would go away on its own.  Current research has demonstrated that this understanding of back pain is flawed; yet many clinicians still hold this belief.

In fact, 85% of people with a single episode of low back pain will likely experience future recurrences and 2-8% of those individuals will develop chronic back pain.

Chronic pain accounts for 75% of all healthcare costs related to low back pain, is second only to the common cold in missed days from work, and is the number one reason for workmen compensation claims.

Considering the burden chronic back pain places on healthcare resources, patient management appears to be an issue in need of addressing appropriately as many patients find it difficult to find effective treatment.

Low Back Treatments That Don't Help
Now many experts are questioning the model in which back pain is treated as a growing body of research suggests many common back pain ‘cures’ just don’t work. These include:

  • Ultrasound
  • TENS machines
  • Strong opium-type painkillers, such as diamorphine
  • Spinal injections
  • Spinal fusion
  • Disc replacement
Prescribing drugs or cutting people open when you don't know what's causing the pain is very unlikely to be successful in the long term. Surgery should only be used as a very last resort. There is a significant lack of efficacy for many treatments, but the deeper issue here seems to be that many healthcare providers have difficulty in accurately identifying the cause of ‘non-specific low back pain’.

Top spine expert, Professor Stuart McGill is the world’s leading spinal biomechanics researcher and has identified common reasons for back pain and the importance of exercise as an intervention for effective treatment.

In Dr. McGill's opinion, based on over 30 years of research, every case of back pain has a cause and the reason many treatments are ineffective is because they are used on a one-size fits-all approach, rarely targeting the underlying problem.
There are many possible causes for back pain, but you must first find the positions and stresses that trigger pain. As Dr. McGill says, finding these positions and stressors allows the provider to formulate a precise diagnosis and a roadmap to recovery. This roadmap is guided exercises that can correct the harmful patterns and build a stable, firm spine.

Addressing Misconceptions
The importance of a firm spine can come as a surprise to many, as the common perception is that your back must be flexible in order to be healthy and pain-free.

The spine must be firm and have strong muscles surrounding it to help transmit forces from the legs and the shoulders while minimizing the stress on the spine. When the muscles of the spine aren’t strong enough, micro-movements can occur that eventually can sensitize the spine and lead to a painful back.

If you have some movements, which are comfortable to build on, this opens the door to conservative management and recovery through guided exercise

However, recommendation of exercise without a clear understanding of movement intolerances and muscles that must be strengthened can also be harmful

Guided Exercise: The #1 Intervention for Low Back Pain
Exercise is essential both to protect and repair your back, but simply hitting the gym or doing Pilates or yoga without knowing the movement patterns that are generating your pain or the ones that will protect and build a pain-free back, has little chance of being effective.

Thanks to exercises specifically targeted at a patient’s problems, we are able to help educate them on proper posture and movement so they do not put damaging load on their spine. The guided exercise model is truly about identifying a patient's underlying back pain generators and educating them on not only how they can get out pain, but also what they can do to keep it from returning.

When you consider that 85% of individuals who have low back pain will experience future recurrences, there must be a priority placed on educating patient's about proper posture, movement, and exercises that build a firm, strong spine. Guided exercises are showing clear efficacy for use in patients with low back pain and should be a staple in their treatment plan.

If you are suffering from low back pain, whatever the cause, consider Gallagher Performance for your evaluation and treatment. Our goal is to relieve your pain while teaching you what you can do to keep the pain from returning.

More related reading:

 
https://gallagherperformance.com/solution-long-term-improvement-back-pain/

 

Before You Go To A Chiropractor, Read This First

Imagine a world where patients get the advise, education, and treatment they need. Imagine doctors who:

  • Make sense of what a patients says
  • Know exactly what a patient needs
  • Confidently provide gold standard advice and treatment interventions
This world is obtainable, but it must first begin with better quality, order and structure to our thinking patterns. One of the fundamental challenges with healthcare is that the human body is amazingly complex and adaptive. In response to the complex nature of dealing with the human body, doctors and therapists may have the tendency to routinely provide services that serve their own skill set better than appropriately addressing the patient's needs. Often times this leaves both the patient frustrated with lack of response to care.

Improving the Quality of Physical Medicine Care
The last 15 years have been great for musculoskeletal healthcare. There are several new treatment procedures and we have developed a deeper understanding of how the body works and how it breaks down. This has had tremendous impact on the world of physical medicine care, and chiropractic profession is no exception. The advancement of musculoskeletal care education has fueled a growing speciality within the chiropractic profession, sports injury & rehabilitation.

While physical therapy is often the first choice for medical doctor referrals in rehabbing an exercise or sports-related injury, there is a growing trend among athletes and individuals who enjoy an active lifestyle to turn to sports injury & rehabilitation chiropractors.

You may be thinking, “I thought chiropractors were only good for treating low back and neck pain and headaches.”
Just like the medical profession, there are many areas of specialty in chiropractic. Those who specialize as a sports injury & rehabilitation chiropractor have undergone the traditional education on joint manipulation or adjustments. However, in addition to their core curriculum, sports injury & rehabilitation complete hundreds of hours in continuing education learning about exercise and sport-related injuries, manual therapy, and functional rehabilitation methods.

What's so special about a sports injury & rehabilitation chiropractor?
Chiropractors who utilize a sports injury & rehabilitation approach incorporate joint mobilization/manipulation, soft-tissue treatments, various manual therapies, and functional rehabilitation techniques to provide a gold standard of care in treatment for individuals with exercise and sport-related injuries.

If you choose to visit a sports injury & rehabilitation chiropractor, you can expect a comprehensive examination before treatment begins. These examinations generally include:
  • A detailed history, orthopedic and neurologic examination, and functional based examination to create a working diagnosis.
  • Functional based examination to focus on the spine, shoulders, hips and feet, as these joints and their respective functions serve as the "key joints" of the human body.
  • Joint and muscle palpation to assess the quality of your joint movement, trigger points, and muscular imbalances.
Once the examination is completed, we want to discuss your specific goals in order to create a customized treatment plan for your road to recovery. The more accurately we assess, the more accurately we can apply treatment. Four types of treatment used at Gallagher Performance for exercise and sports-related injuries are:
  1. CHIROPRACTIC MANIPULATIVE THERAPYGallagher Performance provides the latest techniques, including joint manipulation (adjusting), designed to treat musculoskeletal complaints. The purpose of joint manipulation is to release restricted joints of the body, primarily in the spine and extremities. Joint commonly become restricted as a response to poor posture, imbalanced muscle activity, and/or trauma. By releasing a restricted joint through manipulation, improvements in the quality of motion of the joint are gained that may not be possible with exercise or other interventions. Manipulation also serves to reduce pain and relax tight muscles.
  2. FUNCTIONAL REHABILITATIONIn addition to providing relief through manipulative therapy and treating muscular adhesions, it can prove to be incredibly valuable to identify the source of a patient’s symptoms. The functional approach to rehabilitation includes identifying joint dysfunction, muscular imbalances, trigger points, and faulty movement patterns. These are often the hidden causes of injury. Observing how a patient moves and functions allows us to identify improper movement patterns that become contributors to pain and poor sport performance. By placing an emphasis on strategies to improve movement and function, functional rehabilitation is effective in improving qualities of endurance, strength, stability, balance, agility, coordination, and body awareness.
  3. DYNAMIC NEUROMUSCULAR STABILIZATION (DNS)By applying principles and techniques rooted in the study of child development, DNS aims to improve activation and neural control of muscles and ideal movement patterns. DNS promotes the ideal postures, movements, and degree of body awareness that is essential not only to athleticism, but to also treating the underlying causes of several pain syndromes.
  4. MYOFASCIAL RELEASEGallagher Performance offers a number of soft tissue approaches to treat painful or tight muscles, tendons, and ligaments. We have extensive training in identifying and treating muscular adhesions that compromise quality of motion and contribute to pain symptoms or reduced sports performance. Many overuse or repetitive use conditions respond well to treatment of soft-tissue structures, including back pain, shoulder pain, shin splints, runner’s knee (IT band syndrome), and plantar fasciitis.
If you have any questions or have been struggling with pain related to your activities, exercise or sport, Gallagher Performance offers customized treatment plans to get you our of pain and performing better.

To schedule your appointment, call (724) 519.2833

More related reading:

https://gallagherperformance.com/options-dont-take-insurance/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/resetting-bodys-function-post-injury/

Welcome to Gallagher Performance

[embed]https://www.youtube.com/watch?v=dzaixhJKgnQ[/embed]

Hi. I’m Dr. Sean Gallagher. Welcome to Gallagher Performance. I’d like to tell you about what we have to offer and why it might be a right fit for you to come check us out.

We offer chiropractic, functional rehabilitation, massage therapy, nutritional programs, as well as sports performance and personal training programs.

To begin with, my approach to chiropractic is different from what most have come to expect or have experienced in the past. As a chiropractor, my focus is on returning you to proper function and teaching you what you can do to keep pain from returning. Rather than spending 5 minutes with my patients, I usually spend 30 -60 minutes.

New patient evaluations are an hour long, as this allows me the opportunity to listen and understand their history as well as their desired goals and outcomes from treatment. All new patients receive a neurological and functional-based evaluation as this serves to create a working diagnosis and treatment plan recommendations.

Our functional-based evaluation and treatment plans are focused on looking at how you move so I can figure out strategies to help you move better and ultimately help you understand what could be causing your pain and what you can do to keep it from returning. The process is truly focused on you as the patient and your desired outcomes.

In addition to chiropractic adjustments or manipulations, I perform soft tissue treatments to improve the integrity and function of the muscular system. Massage therapy is offered here as well as it is extremely effective in treating painful or tight muscles and assisting in the healing process. Additional rehabilitation work focuses on improving movement qualities such as endurance, strength, stability, balance, agility, coordination, and body awareness.

When it comes to training, Gallagher Performance is all about individualizing the training process. That’s because we understand each person responds differently to training due to a multitude of factors that must be accounted for. We take time to understand your injury history, training experience, primary sport(s) played, and several other factors. Regardless of whether training occurs in a private or semi-private setting, clients are all closely coached through the entirety of their program to maximize results. This is what separates us and makes us unique from area competitors.

So if you’re looking to improve your performance, whether in sports, the achievement of your health and fitness pursuits, or you just need a tune-up to get your body feeling better, whatever the reason, come see us at Gallagher Performance. We are committed to you achieving your health and fitness goals and would love to be of service to you. Thank you.

Attitude is Everything

Attitude.

We've all heard about it since we were young. We've heard it from parents, family, friends, teachers, and/or coaches who preached the importance of attitude.

Sometimes it takes a certain individual to have an impact in ways others cannot. Likely you have had someone in your life tell you the same thing you've heard countless times before, but for some reason it sticks. It sinks in. These people capture our respect. We feel they are deserving of our attention and we finally listen.

When it came to the importance of attitude, my Uncle Gene was just one person who made a big impact on my views. My uncle served in WWII and when he talked attitude, I listened.

Why?

It had everything to do with that fact that he embodied the message of "Attitude".

During his time serving in WWII, he was on a test flight near Foggia, Italy when a parachute flare bomb failed to release from his B-25. The bomb was hung near the rear hook on the shackle. With the safety wire pulled, the vane was able to spin freely. Realizing the danger of the situation, he climbed down into the bomb bay and, supporting himself with his elbows, he freed the bomb with his feet. For his actions he was awarded the Soldier's Medal for heroism. I have this medal in my bedroom to this day.

Now while his actions were awarded, it was his attitude in that moment that was the clear defining factor.

He was no more physically capable than any others aboard that plane. As a member of the Air Force, these men all had to be in top physical condition to serve our country. It wasn't that he was any bigger or stronger than the next guy. Simply put, in that moment he displayed resourcefulness and selfless courage to step into that situation. His attitude dictated his actions. Because of his attitude and actions, he received recognition for what he accomplished.

In a world where accomplishments matter, attitude matters most.

So what are some key characteristics of the attitudes or mindsets which promote success, be it in sport or in life?

JoAnn Dahlkoetter, Ph.D., author of Your Performing Edge and an internationally recognized sports psychologist, has identified characteristics that make a champion athlete that are able to be developed by anyone who wants to excel in sport:

  • Enthusiasm and Desire – Top athletes have a hunger, a fire inside which fuels their passion to achieve an important goal, regardless of their level of talent or ability.
  • Courage to Succeed - It takes courage to sacrifice, to work out when you’re tired, to seek out tough competition, to stick to your program, to test your limits, and to overcome obstacles.
  • Internal motivation and self-direction – Direction and drive need to come from within. The goals must be ones that you have chosen because that’s exactly what you want to be doing.
  • Commitment to Excellence – Elite athletes know that to excel at their sport, they must decide to make it a priority in their life. They make an honest effort each day to be the best at what they do. At some point you must say, I want to be really good at this; I want this to work.
  • Discipline, Consistency, Organization – Elite athletes love what they do and it is easier for them to maintain consistency in training and in competing. Regardless of personal problems, fatigue, or difficult circumstances, they can generate the optimal amount of excitement and energy to do their best.
  • Being focused and yet relaxed – Champions have the ability to maintain concentration for long periods of time. They can easily let go of distractions and take control of their attention. They don’t let emotions get the best of them and cause poor performance.
  • Ability to handle adversity – Top athletes know how to deal with difficult situations. Adversity builds character, but adversity also reveals character. When elite athletes know the odds are against them they embrace the chance to explore the outer limits of their potential. Rather than avoiding pressure, they feel challenged by it. They are calm and relaxed under fire. Setbacks become an opportunity for learning.
Many of the points simply brings the message back to attitude and the attitude one activity decides to embrace. Attitude is everything and I feel that Charles Swindoll puts this into perspective very nicely:
The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think or say or do. It is more important than appearance, giftedness, or skill. It will make or break a company, a church, a home. The remarkable thing is we have a choice every day regarding the attitudes we will embrace for that day. We cannot change our past...we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude. I am convinced that life is 10% what happens to me and 90% how I react to it. And so it is with you...we are in charge of our Attitudes.
 
More related reading:

https://gallagherperformance.com/sports-training-and-life-after/

Q&A with Quad City Strongman

Quad City Strongman is the premier strength training gym in the QC area. From their experience and knowledge to community involvement, QC Strongman is first class all the way. Learn more about QC Strongman in this interview.

[embed]https://www.youtube.com/watch?v=E3Tq1PTzWEI[/embed]

Fascia & Muscular Adhesions: How they relate to pain and overuse injuries

What is Fascia?
The soft connective tissue, located just under the skin, is a white membrane that wraps and connects muscles, bones, nerves, organs, blood vessels of the body.

This soft tissue is known as fascia. Think of fascia like the white fuzz inside an orange peel connecting and wrapping around the orange and the individual sections or slices.

At times, muscles and fascia are can become stuck or tear, resulting in soft tissue injuries or adhesions. Adhesions restrict movement and the quality of muscular contractions resulting in either soreness, pain, and/or reduced flexibility.

For a quirky take on fascia or "the fuzz", watch this video by Gil Hedley, PhD. The video provides great visuals as to what fascia looks like, how our muscles have to slide while we move, and what muscular adhesions look like and how they limit movement.

[embed]https://www.youtube.com/watch?v=_FtSP-tkSug[/embed]

How do you treat Fascial/Muscular Adhesions?
Treatment of fascial/muscular adhesions through manual or instrument assisted techniques have clinically proven to achieve successful outcomes in many acute and chronic conditions. Gallagher Performance offers a number of soft tissue approaches to treat painful or tight muscles, tendons, and ligaments. We have extensive training in identifying and treating muscular adhesions that compromise quality of motion and contribute to pain symptoms or reduced sports performance. Many overuse or repetitive use conditions respond well to treatment of soft-tissue structures through myofascial release, including back pain, shoulder pain, shin splints, runner’s knee (IT band syndrome), and plantar fasciitis.

Myofascial release is a manual or instrument assisted therapy targeting soft-tissue structures to reduce the presence of adhesive/scar tissue. Adhesive muscular tissue is arguably the most common yet most underdiagnosed condition in the entire human body. Muscular adhesions act like glue among muscles, fascia, tendons, ligaments, and even nerves. As a result, this reduces flexibility, strength, and stability to the body by altering movement control patterns. Adhesive tissue along nerves can cause numbness, aching, tension, tingling, and in some cases weakness. This is condition is called nerve entrapment and can happen in an estimated 150+ locations throughout the body.

How does adhesive tissue develop within the body?
Often adhesive tissue develops in result to acute injury or from overuse/repetitive trauma injury. Overuse injuries are caused by repetitive stress on the muscle and skeletal system without enough rest to allow the body to adapt. Studies show these overuse injuries account for more than half of pediatric sports injuries and often happen due to intensive focus on a single sport with an intensive practice and competition schedule. Unrecognized and untreated, they can sideline athletes from play and lead to more serious injuries.

Who is qualified to diagnose and treat fascial/muscular adhesions?
Sports medicine experts are advocating a greater role for therapists who can help athletes or active individuals recover without incurring lasting damage or hampering their activities. Specialists such as chiropractors, physical therapists, and massage therapists who specialize in sports-related injury and rehabilitation are often the first line of defense in managing and treating overuse injuries. These licensed professional are best for identifying muscular or fascial adhesions as they related to overuse injuries and movement disorders. With specialized training, these professionals are able to detect and treat muscular adhesions, expediting the healing process and minimizing downtime due to overuse injuries.

This is exactly why at Gallagher Performance we have a team which includes a massage therapist and a board certified chiropractic rehabilitation specialist. We strive to offer our athletes and patients the latest treatments and evidence-based soft tissue and rehabilitation techniques. Helping our athletes and patients achieve and sustain their best level of health and performance is our goal.

More related reading:

https://gallagherperformance.com/tendinitis-changing-treatment-and-improving-recovery/

https://gallagherperformance.com/why-stretching-wont-solve-your-tight-muscles/

https://gallagherperformance.com/3-benefits-of-integrated-training-and-therapy/

VBlog: Overtraining a Myth?

This short video discusses the reality of overtraining as it relates to human performance when it matters most. Overtraining is not a myth. Learn more here.

https://www.youtube.com/watch?v=tyYQEVO7QOI

Painful Back? You May Be Hurting It By Stretching

What you need to know:

  • Many healthcare providers and trainers poorly understand how movement of the nervous system relates to several common pain syndromes and musculoskeletal conditions.
  • Dealing with neural tension is not as simple as just stretching. While stretching may feel good, it very easily may aggravate symptoms.
  • Once appropriate treatment of neural tension begins, patients often normalize their movement very quickly and experience pain relief. Often this pain relief is instantaneous.
What is Neural Tension?
Neural tension is rather unheard of yet it often plays a significant role in many pain syndromes and musculoskeletal conditions. We all understand for movement to occur in the body, joints must move and your muscles must contract. But did you know that your nervous system tissue must also move freely and unimpeded during movement?

Neural tension is commonly mistaken for muscle tension. Your nerves were not designed to stretch, but rather to glide and give during movement.
If some form of obstruction (soft tissue or bony) impedes your neural tissue then pain or restriction of normal nerve movement is a common result. This normal nerve movement may only be a matter of millimeters, but nerve tissue is highly sensitive and does not like to stretch. Thus if too much stretch is placed on a nerve, the result is adverse neural tension and that can create pain, limited range of motion, as well as other classical symptoms associated with nerve tissue (numbness, burning, shooting pain, etc.)

Neural Tension Treatment
The movement of your nerves, or neurodynamics, can be assessed by a licensed chiropractor or therapist trained in the process of detecting and treating neural tension. Screens or tests commonly used to identify neural tension help identify not only which nerve(s) have adverse neural tension but also where the nerve is being obstructed during its movement.  Identify where the nerve is being obstructed is critically important because treatment is tailored to the site of obstruction.

Again, this highlights the importance of an accurate assessment as treatment can be more accurately applied to the structure(s) creating adverse neural tension. Once treatment begins, patients often normalize their movement very quickly and experience pain relief. Often this nerve pain relief is instantaneous.

What Conditions Commonly Involve Adverse Neural Tension?
Some common conditions that adverse neural tension often plays a role in or is a complicating factor that must be treated include:
  • Neck Pain
  • Shoulder Pain
  • Tennis Elbow
  • Carpal Tunnel Syndrome
  • Low Back Pain
  • Hip Pain
  • Sciatica
  • Plantar Fasciitis
Stretching vs Nerve Mobilizations
A common misconception in the treatment of back pain and associated muscle tightness is the idea that one must stretch to get relief. Stretching may bring temporary relief, only for one to experience the tightness come back once again or, worse yet, an increase in their pain.

Interestingly, when neural tension is identified as the underlying reason for muscle tightness, the treatment of neural tension doesn't actually involve stretching. Excessive stretching can actually irritate your nerves and increase pain. Excessive stretching may potentially damage your nerves as well.

This should make the message pretty clear - stretching may not be the best thing for your back when it's giving you all the signs that it isn't responding favorably.

Rather than stretching, restricted nerves and the surrounding muscles require a different approach known as nerve mobilizations or nerve sliders. Qualified chiropractors and physical therapists will utilize nerve mobilizations to help entraped nerves slide better during movement. They will also treat the surrounding muscles or tissues that is obstructing your normal nerve movement. After treatment, they will retest your neurodynamics and repeat the process until your full neural movement is restored. This process may take a few treatments to clear up, or take several, depending on severity.

Research Supports Neurodynamics
The concept of neurodynamics or neuromobilization is originally based on the research of Michael Shacklock and David Butler. Over the past several years, further research has added to the scientific support of the concept that your nerve tissue requires full freedom of movement to remain pain-free.

The following excerpts are from Michael Shacklock’s book Clinical Neurodynamics: a new system of musculoskeletal treatment:
"Neurodynamics is an innovative management tool involving conservative decompression of nerves, various neural mobilising techniques and patient education techniques. Neurodynamics offers a fresh understanding and management strategies for common syndromes such as plantar fasciitis, tennis elbow, nerve root disorders, carpal tunnel syndromes and spinal pain."

"Essentially the entire nervous system is a continuous structure and it moves and slides in the body as we move and the movement is related to critical physiological processes such as blood flow to neurones. This movement is quite dramatic and it is not hard to imagine that fluid such as blood in the nerve bed, a constricting scar, inflammation around the nerve or a nerve having to contend with arthritic changes or proximity to an unstable joint could have damaging effects, some of which could lead to pain."
Final Words
Neural tension can be present with many common musculoskeletal conditions, such as back pain. Very often neural tension is easily mistaken for muscle tension, leading many to want to stretch in order to find relief. Stretching can be counterproductive and may aggravate pain symptoms. In order to treat neural tension, it must be examined accordingly. At GP, we are trained in detecting and treating adverse neural tension and why it is present.

If your pain is not resolving with other interventions, consider your pain may be associated with neural tension and you may benefit from the most appropriate course of treatment and client education.

More related reading:

https://gallagherperformance.com/why-stretching-wont-solve-your-tight-muscles/

 

Sports, Training, and Life After

When it comes to writing and keeping up a blog, demands of life and business can make it challenging to find time to sit down and put some good thought into something you hope your readers will either find a degree of value or connection with in reading. Sometimes the best inspiration for writing comes through simple conversation. In this case, I was having a conversation with a parent that generated some thought that got me to thinking I should sit and put my thoughts down.

Knowing some of the physical ailments I deal with on a regular basis from sports, this particular parent of one of our athletes asked me, “Would you do it all again?”

Essentially their implied question being, “Was it worth it?”

Easy answer. I said, “Yes.”

The sports of ice hockey, powerlifting, and Strongman have provided me numerous friendships, lessons, memories, and helped shaped how I approach life. I would never change that.

Keep in mind, while some injuries I sustained playing hockey were severe, what I deal with to this day is relatively minor compared to other athletes.

In fact, while I did sustain injuries during sport participation, I received just as many injuries and set backs in the weight room or in training. This is what I would have changed the most. I would want to go back to change my training habits and attitude when I was in high school and college.

In the late 90s and early 2000s, I was fully invested in training for hockey and had minimal resources. The Internet did not provided the amount of information it has today. I was using magazines or Arnold Schwarzenegger’s Encyclopedia of Modern Bodybuilding to find guidance on what to do when it came to working out and lifting weights. There was truly a lack of training info out there. Similar to most kids my age, reading over the monthly Muscle and Fitness was the closest thing we had to authority on all things bigger and stronger.

There were no seminars. No YouTube tutorials. No blogs or online forums. No ebooks. These didn't exist as a reference to help young, aspiring athletes guide their understanding of training.

Books on training were just as hard to find. As a kid, I absolutely hated to read books. But I had one exception. I loved reading autobiographies on athletes I looked up to. Athletes like Jerry Rice, Herschel Walker, Jaromir Jagr, and Mario Lemieux.

At times, these athletes would discuss what types of workouts they did growing up or still performed in the offseason. I recall reading that Jerry Rice, as a kid, would run after horses to get faster. During his career as the greatest receiver in NFL history, Jerry Rice was well known for always coming into the season in phenomenal condition from brutal offseason workouts. Herschel Walker did 1,000 push-ups per day and was an absolute force on the football field. Jaromir Jagr did 1,000-2,000 bodyweight squats per day as a kid growing up in the Czech Republic and he attributed that to the speed and strength on the puck which made him the arguably the greatest European-born player in NHL history.

At 14, I remember being obsessed with what highly successful athletes did as young kids and I put it all down on paper, writing up my own workouts based on what they did. Lots of bodyweight squats, push-ups, running hills and biking for miles.

So I got to work. I biked 11 miles around my hometown on some days. Others I would run a hilly 3-mile course. And everyday I did bodyweight squats and push-ups, working up to eventually doing 2,000-2,500 squats and 400 push-ups within 75-90 minutes. Plus, my brothers and I would just go outside and play for hours. Didn’t matter what it was. We just played for fun.

I got my first weight set and bench around that same time and took on more of a bodybuilding focus thanks to Arnold and Muscle and Fitness.

The mentality was pushing yourself as hard as you can. More was better. Soreness meant you were doing something right. Complete exhaustion or puking meant you had a good conditioning workout. This was my mentality through high school and into college. I figured if it worked for some of the best athletes on the planet, it surely had to work for me.

The problem became I wasn't getting much bigger or much stronger. Sure there were initial benefits during the early years. See when you are young; if you show up, train hard and keep adding weight to the bar, it works!  It works so well that it’s what I figured I could keep doing. But what no one ever told me was it only works for so long. You eventually reach a point of diminishing returns.

At a certain point, I had to seek out the help of a sports-trainer and that was hard to find back in 2000. My brother and I were heading into 12th grade and had a big showcase tournament coming up that summer. My dad was able to track down a guy for my brother and I to train with in preparation for that tournament. Under his guidance and direction, I was able to see improvements in size, strength, and speed that I was unable to achieve on my own.

What did he do for me that I couldn’t figure out on my own?

He knew that I needed to get more explosive, more dynamic, better conditioned for my sport. What I didn't understand is that sometimes success from things you have done in the past is the worst indicator of what should be done next.

Lesson learned.

Then I think back on my college hockey career and the years I have spent competing as a strength athlete in both powerlifting and Strongman. The muscle imbalances and movement restrictions that started to creep in because of poorly structured training programs. There were plenty more lessons I learned about intelligent training structure and program design from a number of various injuries and setbacks.

Hockey, Powerlifting, and Strongman have all influenced me somehow from a training perspective. I wouldn't change anything about participating in these sports; I would change my preparation for them.

I feel bad for kids these days. I feel they have it worse then my generation. They have been duped into thinking they will be better athletes from participating in one sport. They are being sold speed ladders, specialty camps, and mass marketing fitness trends. I grew up with out any experts, now kids today are growing up with “experts” everywhere. They are being robbed of the option of playing multiple sports by coaches who demand their involvement in one sport throughout the calendar year. They are forced into specialization too early. And when it finally is time to specialize, they have no base of athleticism or strength because those attributes have been ignored due to lack of free play. You can’t build upon a poorly established base and that is why youth sport injuries are continually on the rise. I share the opinion that this is why the fastest growing surgery is pediatric.

So to answer the question of a concerned parent, don't be concerned about the game or the sport or whatever your kid chooses. You should be concerned about the lack of free play, the lack of movement and variability, the lack of smart training. Take interest in that. I believe this to be the important part.

More related reading:

https://gallagherperformance.com/interview-with-mike-odonnell-dc-ccsp-cscs/

https://gallagherperformance.com/attitude-is-everything/

https://gallagherperformance.com/performance-training/athletic-development/

VBlog: Olympic Lifts and Training

The Olympic Lifts of the clean & jerk and snatch, as well as their variations, are commonly used to develop power and even as metabolic conditioning. What exactly is their role in training? We address our views in this short video.

https://www.youtube.com/watch?v=ZVdjYkeq2AA

Dynamic Neuromuscular Stabilization: Advancing Therapy & Performance

Here at Gallagher Performance we not only strive to provide the best in chiropractic, rehabilitation and manual medicine treatments for our patients, but we also utilize comprehensive diagnostic methods and tools to help determine which treatment is best for you. This allows us to apply to most ideal therapeutic interventions. At GP, this could include any combination of the following: chiropractic manipulative therapy, manual therapy according to Lewit and Janda, Vojta Therapy, myofascial release, trigger point therapy, neuromobilizations, and dynamic neuromuscular stabilization (DNS).

Despite many of our patients having previous experience with chiropractic or physical therapy, they are unfamiliar with DNS. Gallagher Performance specializes in DNS therapy. Dr. Gallagher has been studying and utilizing DNS since 2007. His extensive training and background allows him to provide a level of care that is unique to the Pittsburgh area.

Since DNS has implications in both physical rehabilitation and training, we spend a great deal of time educating our patients and clients on DNS and answering some frequency asked questions. With that in mind, the goal of this article is to help educate our readers about DNS and the significance this intervention has as it relates to pain or sports performance.

What is DNS therapy?
DNS is a revolutionary European approach in the treatment of back pain and several neuromuscular conditions. DNS therapy is based on the neuroplasticity of the Central Nervous System and targets the cause of pain/dysfunction rather than its manifestations. DNS therapy evokes ideal movement patterns by manual stimulation of developmental reflex zones and utilizes specific exercises to improve neuromuscular control. The therapeutic benefits become significantly expanded from previous standards of rehabilitation. Any one from infants to adolescents, chronic pain patients to athletes can all benefit from DNS therapy.

How does DNS compliment chiropractic adjustments? 
DNS therapy favorably compliments traditional chiropractic adjustments in several ways. When patients may be apprehensive about receiving an aggressive or forceful chiropractic adjustment, DNS offers gentle, non-forceful, low velocity manipulation that is well tolerated and safe. For those that receive traditional chiropractic adjustments, DNS works in concert to normalize joint function and restore muscular balance, leading to more sustainable improvements in reduced pain and improved function.

Often times, symptom relief experienced from a chiropractic adjustment can be short-lived with symptoms returning rather quickly. In contrast, when DNS is applied in a chiropractic setting, the approach allows for longer-lasting symptom relief due to therapy’s ability to improve Central Nervous System (CNS) coordination and joint stability which is then maintained by performing prescribed home exercises.

DNS therapy simply enables a chiropractor to effectively treat and manage a broad range of musculoskeletal and neurological disorders. While traditional chiropractic may be limited in what can be done through chiropractic adjustments and passive modalities, DNS represents a powerful alternative to chiropractic care when dealing with pain syndromes and more complex structural pathologies where the effectiveness of traditional chiropractic is highly limited.

How is DNS therapy able to get me out of pain and moving better when other conservative therapies have failed?
The results achieved by DNS therapy are often difficult to achieve with traditional methods used by chiropractors and physical therapists due to the physiological phenomenon that occurs during treatment to minimize muscular imbalances, relieving painful protective muscle spasms, resulting in a more stable musculoskeletal system with improved spinal stability and postural awareness.

During DNS therapy, induced movements are controlled not locally, but by the higher levels of the Central Nervous System. This then results in faster and longer-lasting improvement in function and pain relief.  When combined with exercise, the promotion of joint stability and ideal movement becomes habitual and independent of conscious effort.

How are DNS exercises different from traditional physical therapy or physical training exercises?
In the majority of physical therapy and chiropractic clinics, as well as in personal training settings, exercises are performed that simply train muscles in isolation. The patient who has shoulder pain and is only prescribed shoulder exercises illustrates this concept. The fault in strengthening weakened muscles through isolation training is that isolation training will fail to unify the painful or problematic joint with the entire locomotor system. Sure you can perform all the isolation exercises you wish, but this does not guarantee that the strength or coordination gained will automatically transform into adequate performance.

DNS exercises are applied in accordance with development kinesiology or essentially how we develop motor function during childhood. As we develop, reflexive movements (primitive, postural, locomotor) become more refined and coordinated, ultimately leading to specific movements we produce later in life such as walking, running, jumping, reaching, throwing, etc.

However, developing these skills does not happen magically.  Learning to control the body and developing fundamental skills make up our motor milestones.  These milestones mark critical points in our development and there is a progression that these milestones follow.  This is known as developmental kinesiology. In simplistic terms, we need to be able to lift our head and support it, roll over, crawl, support ourselves upright, walk with assistance, and then walk without support.

The understanding of developmental kinesiology and critical motor milestones allows the provider to make exercise progressions and regressions during the course of therapy in order to appropriately address the underlying locomotor system dysfunction(s).

These exercises are applicable for patients with variety of acute and chronic conditions as well as for athletes who are trying to improve their performance and also prevent or rehabilitate injuries.

Often DNS exercises are conducted with active support from the clinician to insure that the patient maintains proper support and executes ideal movement. DNS exercises could include the use of stability balls or bands to further facilitate the desired response of the exercise.  These exercises are not only used to improve the stability of the spine, muscle coordination, balance and strength, but also to increase the body’s awareness and sensory integration.

Conclusion
All of a sudden, conservative management and treatment of patients and training of athletes looks a lot different than what is traditional accepted.

DNS is not only a magnificent approach for preventing and rehabilitating pain syndromes in the movement system it is also becoming extremely popular in sports performance circles. The same ideal patterns that keep an individual out of pain also maximize the efficiency of the movements, which not only reduces risk of injury but improves performance.

When you consider the principles of DNS, it truly is not about what exercises we prescribe or what exercises we perform, but rather what we are actually getting from those exercises when we perform them that is important. DNS provides a system of evaluation and treatment which follows motor development, thus providing an effective way to help our patients get the most out of therapy and our clients get the most out of training.

Sources:
Dynamic Neuromuscular Stabilization & Sports Rehabilitation, Frank C, Kobesova A, Kolar P. Int J Sports Phys Ther. , 2013 Feb;8(1):62-73.
A case study utilizing Vojta/Dynamic Neuromuscular Stabilization therapy to control symptoms of a chronic migraine sufferer, Juehring DD, Barber MR. J Bodyw Mov Ther, 2011 Oct;15(4):538-41.
Cerebellar function and hypermobility in patients with idiopathic scoliosis, Kobesova A, Drdakova L, Andel R, Kolar P. International Musculoskeletal Medicine. , 2013, 35(3): 99-105.
Effects of shoulder girdle dynamic stabilization exercise on hand muscle strength., Kobesova A, Dzvonik J, Kolar P, Sardina A, Andel R. Isokinetics and exercise Science. , 2015;23:21-32, 
Developmental Kinesiology: Three Levels of Motor Control i the Assessment and Treatment of the Motor System. Kobesova A, Kolar P. Journal of Bodywork and Movement Therapies., 2014;18(1):23-33.
The Prague School of Rehabilitation, Kobesova A, Osborne N. International Musculoskeletal Medicine, 2012;34(2):39-41.
Postural - Locomotion Function in the Diagnosis and Treatment of Movement Disorders, Kolar P, Kobesova A. Clinical Chiropractic, 2010;13(1):58-68.
Analysis of Diaphragm Movement during Tidal Breathing and during its Activation while Breath Holding Using MRI Synchronized with Spirometry. Kolar P, Neuwirth J, Sanda J, Suchanek V, Svata Z, Volejnik J, Pivec M. Physiol Res, 2009;58(3):383-92.
Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain. Kolar P, Sulc J, Kyncl M, Sanda J, Cakrt O, Andel R, Kumagai K, Kobesova A. J Orthop Sports Phys Ther, 2012;42:352-362.
Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment, Kolar P, Sulc J, Kyncl M, Sanda J, Neuwirth J, Bokarius AV, Kriz J, Kobesova A. J Appl Physiol. , 2012;42(4):352-62.
Importance of Developmental Kinesiology for Manual Medicine, Kolar P. translated from Czech Journal of Rehabilitation and Physical Therapy, 1996;4:139-143.
Surgical treatment and motor development in patients suffering from cerebral palsy, Kolar P. Translated from Czech Journal of Rehabilitation and Physical Therapy, 2001;8(4):165-168.
Long-Term Efficacy of Dynamic Neuromuscular Stabilization in Treatment of Chronic Musculoskeletal Pain, Bokarius AV, Bokarius V. 12th World Congress on Pain. Glasgow, Scotland. Aug 17-22, 2008. Presentation # PF225.
A case study utilizing spinal manipulation and dynamic neuromuscular stabilization care to enhance function of a post cerebrovascular accident patient, Oppelt M,Juehring D,Sorgenfrey G, Harvey PJ, Larkin-Thier SM. Journal of Bodywork and Movement Therapies., 2014;18:17-22.
More related reading:

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

Assumptions, Accusations, and PEDs

The controversial subject of individuals assuming and accusing other individuals of using PEDs has been brought up once again.

It's comical to me because I always here about these assumptions or accusations from a second hand source. I never hear it directly from the source. But, that's another story.

At this point in my life, I’ve heard it since I was in college. Not just me, my brothers as well.

Let me make something perfectly clear: I am a natural athlete. Ryan is a natural athlete. My brothers are natural athletes. Always have been, always will be.

Why I am writing this post is to ask the question, "Why do people assume someone is using PEDs or anabolics in the first place?"

Is it because they believe something is not possible?

Do they have this belief because they are not capable of the same achievement? Or do they believe that because they can’t do it, then no one can?

Do they somehow believe that they are the strongest natural athlete alive and if someone is stronger than them, that person is a cheat?

Looking deeper in the matter, I consider the attitude of the individual making the assumptions or accusations. They start with the attitude that they believe what others are achieving is not possible, all based on the belief that it is not possible for them. And the impossible will always be their reality, never achieving what they are truly capable of because a driven, motivated person will make it possible. They will always find a way and won’t quit. They will never allow themselves to believe something is not possible.

Want to know the secret of the strong?

It all starts will their mentality.

A stronger person will never question the abilities of a weaker person. It’s always the weak questioning the strong. Weak in mind and character will always equal weak in strength. The strong simply want it more. Strength begins with a change in attitude. Put your mind to it. Change your attitude. Put forth some real focus and thought to achieving your goals and forget what others say is or isn’t possible.

Besides, who sets the limit of natural strength and athletic ability?

Why do people feel the need to define what someone else is capable of or tell them what their limitations are and if they have been reached. The strong of mind and the driven athlete are made to push boundaries and create new limits. Ignore the haters and detractors. It’s up to us to impose the stressors needed for adaptation and elevated performance. Put in the work and the time. Remember, nothing worthwhile ever came from quick and easy. Strength is no different.

Don't fall victim to the poorly educated and allow them to shape your views on the limits of human potential and what is or what is not possible. You’ll be amazed at what can be achieved without the excuses and with plenty commitment, consistency, time, failure and above all hard work.

More related reading:

https://gallagherperformance.com/training-take-it-seriously/

https://gallagherperformance.com/advanced-training-for-elite-athletes/

FAQs: Frequency Avoided Questions of Strength & Conditioning

It’s time to understand what training for an athlete is all about. Parents and athletes are seeking out training services in great numbers and are confronted with more options year after year.

A real problem for people is that they see stuff like P90X, Crossfit, bodybuilding style training, or any kind of general fitness training and they get confused into believing that it is good training for an athlete. What they need to understand is that these training styles do not necessarily give you high performance. Many times adults and their young athletes fall into the trap of pursuing training without truly understanding if it will be beneficial or detrimental to their athletic development. What we have compiled below are some common FAQs or Frequently Avoided Questions that should be answered before you begin an organized training program aimed at developing a young athlete.

1) What are the demands of the sport?
Does your strength coach/personal trainer actually account for the sport you participate in, understanding the biodynamics and bioenergetics of the sport and adjusting your training accordingly? Or do they simply plug you into their system and make you workout based on what they know how to do, not what you need as an athlete? Understanding the anatomy and physiology of sport is highly critical in the design of athletic and sport performance training. If you’re coach or trainer does not understand these concepts as they relate to your young athlete’s sport(s) of participation, they will fail to produce significant results.

Don't buy into "functional training" hype. Simply ask them, how exactly is this functional for my young athlete? You'll be surprised at the sales pitch you may hear.

Read more:

What is Functional Exercise?
Training for Elite Athletes
Identifying Strength Needs for Athletes
Guidelines for Selecting a Strength Coach or Personal Trainer
2) How does training impact a young athlete’s muscle fiber typing?
Muscle fiber typing is specific to slow and fast twitch muscle fibers. Understand that slow twitch muscle fibers are highly resistance to fatigue and do not produce much force, making them more favorable for use during distance/endurance training and lighter resistance training workouts. Fast twitch muscle fibers are more easily fatigued but they produce a great deal of force and are needed to be fast, explosive, and strong.

Coaches and trainers can run the risk of any transitional muscle fibers being pushed to low threshold, high endurance-based muscle fibers when they make power-speed athletes do far too much distance endurance training or high rep weight training. Power-speed athletes make up the bulk of team sports such as football, hockey, baseball, basketball, and track & field events such as sprinters, throwers, and jumpers. This is not a comprehensive list, but none the less provides you with an understanding of just how many sports are highly dependent on power-speed qualities.

Athletes need to utilize training methods that push transitional muscle fibers to a more high-threshold, fast-twitch muscle fibers.  Transitional muscle fibers are highly sensitive in the young athlete, especially in the teenage years.  If improper training methods are utilize, you will lower their ceiling of athletic potential.

Read more:

Common Mistakes in Developing Young Athletes
Success or Failure: What Are You Setting Your Young Athlete Up For?
Two Common Misconceptions in Endurance Training
3) Does quick feet training make sense for an athlete?
The majority of quick feet training involves the use of dot drills and speed ladders. These drills do nothing to reinforce proper mechanics of sprinting or ice skating. Just watch for yourself. When these drills are performed, kids are standing upright with minimal hip and knee bend utilizing short, choppy strides that impart very little force into the ground. This is completely contradictory to what any sprint or skating coach would demand from their athletes. The fastest guys are the strongest guys because they put more force into the ground. Quick feet training makes no sense.

Read more:

Don't Fall for the Speed Trap
Choose Consistency and Intelligence in Training, Forget the Rest
4) Does high rep weight training for time make sense?
The whole point of strength training is to improve the efficiency of how your nervous system works. The heavier the weight, the more motor units and muscle fibers your brain needs to call upon to execute the movement. The more motor units and muscle fibers in use, the more force you produce. But we just don't need force, but athletes need to produce force quickly. The faster they produce high amounts of force, the faster and more explosive they become. Pretty simple.

Your brain will not call upon a lot of muscle fibers to execute a movement against light weights. This process of selection exists on a continuum and you don’t get to high-threshold, fast-twitch muscle fibers until you start hitting close to 80% of your 1RM (rep max) or higher. It doesn’t matter how many reps you can do against light resistance. So while the P90X and Crossfit people are doing tons of reps with light weights and little to no rest intervals, you’ll never tap into those muscle fibers that power-speed athletes thrive on for success in their sport.

It’s the complete opposite training you want to do for athletics like football, baseball, hockey, basketball, and just about every power-speed track & field event. Especially for teenagers because you can influence the muscle fiber make-up and the ratio of slow twitch to fast twitch fibers of young athletes. This will have tremendous impact of the athletic development or destruction.  Again, high rep weight training with little to no rest serves no purpose for a young athlete and contradicts the demands of athletics.

Read more:

Drop the Confusion, Athletes Need Consistency for Efficiency
Have You Mastered Your Movement?
3 Reasons You Should Train for Maximal Strength
Why Athletes Should Avoid HIIT Programs